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Analysis of the Effectiveness of Transradial Access Puncture in the Application of Complications and Comfort after Cerebral Angiography. Emerg Med Int 2022; 2022:3457034. [PMID: 36267143 PMCID: PMC9578911 DOI: 10.1155/2022/3457034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/09/2022] [Accepted: 09/24/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate the analysis of the effectiveness of transradial access puncture in the application of complications and comfort after cerebral angiography. Methods Retrospectively analyzed 80 patients who met the inclusion and exclusion criteria and were randomly divided into the control group (femoral artery group n = 40) and test group (radial artery group n = 40) using a random number table from January 2021 to January 2022 admitted to the department of neurology and department of vascular interventions in our hospital and compared the incidence of postoperative puncture site bleeding, time to first postoperative urination, and incidence of postoperative urinary retention and postoperative changes in comfort level. Results There was 1 case of postoperative puncture site bleeding in the test group and 6 cases of postoperative puncture site bleeding in the control group, with statistically significant differences (P < 0.05); the time to first urination in the test group (62.47) was significantly better than that in the control group (85.97), with statistically significant differences (P < 0.05); there were 0 cases of urinary retention in the test group and 6 cases in the control group, with statistically significant differences (P < 0.05). The GCQ scores of patients in the test group were significantly higher than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion Transradial access puncture has a good clinical effect and can effectively reduce the complication rate of patients, which is worth promoting.
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Liu W, Wu M, Wang X, Huang XK, Cai WJ, Ding TY, Duan LL, Qiao R, Wu YG. Recanalization of thrombosed aneurysmal hemodialysis arterovenous fistulas using a hybrid technique based on data from a single center. BMC Nephrol 2022; 23:185. [PMID: 35568810 PMCID: PMC9107707 DOI: 10.1186/s12882-022-02820-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/10/2022] [Indexed: 11/19/2022] Open
Abstract
Objective To explore the technical specifications and clinical outcomes of thrombosed aneurysmal haemodialysis arteriovenous fistula (AVF) treated with ultrasound-guided percutaneous transluminal angioplasty combined with minimal aneurysmotomy. Methods This case series study included 11 patients who had thrombosed aneurysmal AVF and underwent salvage procedures over a 13-month period. All procedures were performed under duplex guidance. Minimal aneurysmotomy was performed, along with manual thrombectomy and thrombolytic agent infusion, followed by angioplasty to macerate the thrombus and sufficiently dilate potential stenoses. A successful procedure was defined as immediate restoration of flow through the AVF. Results The 11 patients (four males and seven females) had a mean age of 49.6 years ± 11.9 years. Six patients (54.5%) had two or more aneurysms. The mean aneurysm maximal diameter was 21.5 mm (standard deviation: ± 5.0 mm), and the mean thrombus length was 12.9 cm (8–22 cm). Ten (83.3%) of the 12 procedures were technically successful. The mean duration of operation was 150.9 minutes (standard deviation: ± 34.2 minutes), and mean postoperative AVF blood flow was 728.6 ml/min (standard deviation: ± 53.7 mi/min). The resumption of hemodialysis was successful in all 11 cases, with a clinical success rate of 100%. The primary patency rates were 90.0% and 75.0% at three and four months over a mean follow-up time of 6.3 months (3–12 months). The secondary patency rates were 90.4% at three and four months. Conclusion A hybrid approach combining ultrasound-guided percutaneous transluminal angioplasty and minimal aneurysmotomy might be a safe and effective method for thrombosed aneurysmal AVF salvage.
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Affiliation(s)
- Wei Liu
- Department of Nephropathy, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, P.R. China.,Department of Nephropathy, Anqing Municipal Hospital, Anqing, Anhui, 246000, P.R. China
| | - Meng Wu
- Department of Nephropathy, Anqing Municipal Hospital, Anqing, Anhui, 246000, P.R. China
| | - Xu Wang
- Department of Nephropathy, Anqing Municipal Hospital, Anqing, Anhui, 246000, P.R. China
| | - Xiao-Kang Huang
- Department of Nephropathy, Anqing Municipal Hospital, Anqing, Anhui, 246000, P.R. China
| | - Wen-Jiao Cai
- Department of Nephropathy, Anqing Municipal Hospital, Anqing, Anhui, 246000, P.R. China
| | - Teng-Yun Ding
- Department of Ultrasonography, Anqing Municipal Hospital, Anqing, Anhui, 246000, P.R. China
| | - Liang-Liang Duan
- Department of Nephropathy, Anqing Municipal Hospital, Anqing, Anhui, 246000, P.R. China
| | - Rui Qiao
- Department of Cardiology, Anqing Municipal Hospital, Anqing, Anhui, 246000, P.R. China
| | - Yong-Gui Wu
- Department of Nephropathy, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, P.R. China. .,Center for Scientific Research, Anhui Medical University, Hefei, Anhui, 230022, P.R. China.
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Yeo CB, Yong E, Hong Q, Kwan J, Quek LHH, Pua U, Punamiya S, Chandrasekar S, Tan GWL, Lo ZJ. Outcomes of Catheter-Directed Thrombolysis for Arteriovenous Fistula Thrombosis in Singapore: Is It Still Relevant Today? Ann Vasc Dis 2021; 14:5-10. [PMID: 33786093 PMCID: PMC7991696 DOI: 10.3400/avd.oa.20-00112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective: To review the outcomes of catheter-directed thrombolysis (CDT) for salvage of thrombosed arteriovenous fistula (AVF) in a single centre in Southeast Asia. Methods: A retrospective study of CDT in AVF between January 2015 and July 2018 at a tertiary university hospital was carried out. Results: Within the study period, 85 patients underwent CDT for AVF thrombosis. Of these patients, 78% underwent CDT for 24 h and 12% required CDT for 48 h. Moreover, 14% of patients had bleeding during CDT and hence required a decrease in dosing or complete cessation. Incidence of intracranial haemorrhage was 1%, and technical success was 92%. Post CDT, primary patency rates at 12, 24 and 36 months were 87%, 62% and 36%, respectively; assisted primary patency rates at 12, 24 and 36 months were 96%, 82% and 69%, respectively; and secondary patency rates at 12, 24 and 36 months were 99%, 93% and 86%, respectively. Multivariate analysis did not identify any predictive factors for patency post CDT. Conclusion: Within our study population, CDT for AVF salvage conferred good technical results with low rates of complications. There was good primary patency at 12 months, and the results were sustained up to 36 months. It remains a useful modality for fistula salvage, avoiding surgical intervention.
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Affiliation(s)
- Clarice Biru Yeo
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Enming Yong
- Vascular and Endovascular Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore
| | - Qiantai Hong
- Vascular and Endovascular Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore
| | - Justin Kwan
- Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - Lawrence Han Hwee Quek
- Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - Uei Pua
- Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - Sundeep Punamiya
- Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - Sadhana Chandrasekar
- Vascular and Endovascular Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore
| | - Glenn Wei Leong Tan
- Vascular and Endovascular Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore
| | - Zhiwen Joseph Lo
- Vascular and Endovascular Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore
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